Talking about diabetes – improving health, one sentence at a time

Some of the research team, from L to R: Rachel Tester, Tony Dowell, Maria Stubbe, from the University of Otago, Wellington.

Primary care physicians can improve their communication to newly-diagnosed diabetes patients by offering more information specific to the patient’s experience, new research from Otago, Auckland and Victoria universities shows.

The study, just published in the international journal Annals of Family Medicine, highlights the importance of good and appropriate communication by healthcare professionals to patients.

For six months, the researchers tracked and videoed all the interactions between healthcare professionals and 32 patients newly diagnosed with type 2 diabetes.

“Despite many health professionals having high communication and technical skill levels, our study found that there are many opportunities to communicate and consult more effectively with these patients,” says lead author Professor Tony Dowell from the University of Otago, Wellington.

The research team found strengths in primary care interactions including high levels of communication skills, enthusiasm to coordinate services, and significant allocation of time with patients.

But for optimal care, better communication is needed.

The study found that initial consultations between primary care clinicians and patients who are newly diagnosed with type 2 diabetes are often driven by biomedical explanations which are out of context from patient experience.

“Patients who have just been diagnosed with diabetes or other long-term conditions bring their own expertise and experience to the situation and healthcare professionals need to listen to this. We need to re-think our usage of technical biomedical language when talking to these patients,” Professor Dowell suggests.

“Despite the high levels of generic communication expertise by clinicians, many patients found the style and content of health promotion and lifestyle advice did not apply to their lives.”

Patients were also concerned about the overuse of checklists, and suggested a need for more effective methods of sharing patient information.

Professor Dowell and colleagues note there was also a perception of time pressure but considerable time was spent with patients by health professionals repeating information that may not be relevant to patient need.

“The time that patients spend with health providers could be allocated more effectively and efficiently when patients see multiple clinicians,” he says.

“Although there has been a huge amount of research into diabetes, this is the first study to directly observe the patient journey and interactions with different health professionals from the onset of diabetes.

“Our results highlight the important role that communication plays in diabetes management, and the overall commitment of primary care teams to delivering patient care,” Professor Dowell says.

The authors recommend that clinicians employ a framework for communications with diabetes patients that acknowledges the importance of the patient’s own particular situation and social needs. They suggest that time could be allocated more effectively and efficiently when patients see multiple clinicians.

“Our main aim is to improve our patients’ health, and this research shows that appropriate communication with patients is a key component.

“The research makes us appreciate the importance of listening more and possibly talking less in consultations. It helps with understanding and improving health care one sentence at a time,” says Prof Dowell.

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